Williamslaursen9034
To determine the pulmonary functions in patients with chronic kidney diseases (CKD) and factors affecting them.
Observational study.
Nephrology Department, Mayo Hospital, Lahore, from October 2018 to April 2019.
All patients of CKD, coming in Nephrology OPD, were included. Patients on maintenance hemodialysis (HD), chronic obstructive pulmonary disease (COPD), smokers, chronic heart disease, and neuromuscular diseases were excluded from the study. Demographic data, physical examination findings and laboratory parameters were taken. Patients underwent spirometry at Pulmonology Department for measurement of forced expiratory volume in the first second (FEV1), forced vital capacity (FVC) and FEV1/FVC.
One hundred and forty patients were included in the study. Mean GFR was 27.75 ± 17.49 ml/min/1.73m2 and 7(5%) patients belonged to stage 2 CKD, 48 (34.3%) belonged to stage 3 CKD, 45 (32.1%) belonged to stage 4 CKD and rest 40 (28.6%) were from stage 5 CKD. Pulmonary functions were FEV1 (90.81±25.84), FVCactors affecting the pulmonary functions were progression of CKD, falling hemoglobin level, monthly income and education. Drop in GFR and anemia had negative correlation and age had positive correlation with pulmonary functions. Key Words CKD, Pulmonary functions, Restrictive lung disease, GFR, Anemia.
To evaluate the outcome of primary repair in penetrating duodenal injuries.
Descriptive study.
Adana City Training and Research Hospital, Adana, Turkey, between March 2011 and September 2018 Methodology Patients with penetrating duodenal injury, who underwent primary repai, were reviewed retrospectively. The patients who had early death, grade 1 duodenum injuries and operative procedures except primary repair, were excluded from the study. Age, gender, mechanism of penetrating injury, grade of the duodenal injury, associated intra-abdominal injuries, length of intensive care unit and hospital stay, duodenum-related mortality and morbidity were analysed. Fisher's exact test was used to compare the outcomes between survivor and non-survivor groups.
Data of 26 patients with primary repair (5 females, 21 males) were reviewed. The mean age was 33.11 ±12.07 years; and gunshot (n=19, 73.1%) was the most common cause of the duodenal injury. Twenty-five had a total of 103 (3.9 injuries per patient) associated ted mortality was low, for this reason minimally invasive procedures such as primary repair will be more accurate in surgical management of penetrating duodenal injuries. Key Words Duodenal injury, Primary repair, Surgical management.
To determine the effectiveness of Sectra visualisation table (SVT) in a public sector setup and to compare the traditional (TRAD) lecture with SVT-aided teaching in terms of learning outcomes and students' perception regarding SVT.
Cross-sectional study.
Jinnah Sindh Medical University, from October to November 2018.
Entire batch of BDS (Bachelors of Dental Surgery) i.e. 50 students were randomly distributed in TRAD and SVT groups, both were exposed to 3 sessions of 1-hour duration. TRAD group attended lecture sessions; whereas SVT group were exposed to SVT-aided teaching. Test was conducted at the end of each session. To compare the scores, independent sample t test was done. Percentages of feedback of SVT group was obtained on Microsoft excel. VAK questionnaire was used to identify learning styles of SVT group, and its association with their performance was obtained by chi square test.
Scores of MCQs test between the groups showed non-significant difference (p = 0.24). Positive feedback was obtained in favour of SVT. Students of SVT group exposed to visual style of learning performed better.
SVT cannot totally replace traditional lecture, although it is a promising tool which can be introduced in the curriculum to enrich the learning experience of students. Key Words Traditional method, Sectra visualisation table, MCQs test, Feedback, Learning style.
SVT cannot totally replace traditional lecture, although it is a promising tool which can be introduced in the curriculum to enrich the learning experience of students. Key Words Traditional method, Sectra visualisation table, MCQs test, Feedback, Learning style.Parachute mitral valve is a rare congenital heart defect characterised by a distorted mitral geometry with a single papillary muscle for all mitral chords to attach. It may develop in isolation or as a constillation of Shone syndrome. By comprehensive retrieval of the pertinent articles published since 2000, 22 articles with 149 cases of parachute mitral valve were recruited into this study. The present article revealed that most patients with a parachute mitral valve had a stenotic or regurgitant mitral valve, which is often associated with left heart obstructions, thereby leading to haemodynamic compromise. Therefore, multiple surgical maneuvers are warranted for such patients. Mitral valve repair is preferred over mitral valve replacement for the mitral valve abnormalities so as to avoid the associated complications of valve replacement procedure. The patients' outcomes are satisfactory with a total event-free survival of surgical patients of 84.8%. Key Words Cardiac surgical procedures, Congenital heart defects, Mitral valve.
To determine the clinical presentation of Addison's disease in order to increase the awareness of presentation in Pakistani children.
Observational study.
Department of Diabetes and Endocrinology, National Institute of Child Health, Karachi, Pakistan, from 2015 to 2019.
Sixty-three children of Addison's disease were enrolled in the study, who have visited and facilitated from the services of National Institute of Child Health from urban and rural region of the Sindh province. Diagnosis were made through biochemical analysis and detailed examination of acute and chronic symptoms. Study was initiated after taking the approval from Institutional Review Board. Moreover, written informed consents were also taken from each of the study participant.
There were 36 boys and 27 girls with a mean age at diagnosis of 3.92 and 4.96 years, respectively. Twelve patients were presented with an adrenal crisis following an acute illness. All of them had hyponatraemia; however, 10 had a hyperkalaemia and 8 had been reloss, lethargy, and poor response in activities. Moreover 15 of them were identified with associated disorder (autoimmune polyendocrinopattay syndrome (APS), Allgrove or triple A syndrome, and adrenoleukodystrophy). Conclusion Typical and atypical presentations of Addison's disease in children of Pakistani population are defined in this study which may assist in better management of Addison's patients. Key Words Adrenal crisis, Hyponatremia, Hyperkalemia, APS, Allgrove, Adrenoleukodystrophy.
To evaluate the outcomes of videothoracoscopic and open surgeries for pulmonary hydatid cysts.
Descriptive study.
Department of Thoracic Surgery, Faculty of Medicine, Balıkesir University, Turkey, between May 2015 and March 2020.
Patients who underwent surgery for pulmonary hydatid cysts were evaluated retrospectively, for the age, gender, symptoms, cyst size and localisation, preferred surgery, duration of surgery, the extent of the intraoperative bleeding, duration of the chest drainage, hospitalisation time, and postoperative complications. The relationship between the categorical variables was examined with the Chi-square and Fisher's exact tests and the relationship between the non-parametric data and continuous variables with the Mann-Whitney U-test.
A total of 60 patients included in the study; 23 underwent videothoracoscopic surgery and 37 had thoracotomy. There were no statistically significant differences between groups as gender, age, location and size of cyst. The videothoracoscopic surgery has superiority to thoracotomy group in terms of lower duration of operation, less perioperative bleeding (p = 0.005), early chest tube removal and lower hospitalisation time (both p <0.001). But there were no statistical difference between groups in complication rates (p = 0.340).
Videothoracoscopic removal of pulmonary hydatid cyst is a safe and advantageous procedure comparing to thoracotomy. selleck There is a need for prospective studies with a larger sample size. Key Words Hydatid cyst, Thoracoscopic surgery, Thoracotomy, VATS.
Videothoracoscopic removal of pulmonary hydatid cyst is a safe and advantageous procedure comparing to thoracotomy. There is a need for prospective studies with a larger sample size. Key Words Hydatid cyst, Thoracoscopic surgery, Thoracotomy, VATS.
To evaluate the efficacy and safety of the semi-rigid URS with pneumatic lithotripsy for the treatment of large (>10 mm) proximal ureteral calculi.
Cohort study.
Section of Urology, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan, from January 2010 to December 2018.
All patients with single, radio-opaque unilateral proximal ureteral stones >10 mm were included in the study. Patients with urosepsis, pregnancy, solitary kidney, and indwelling JJ stent or prior percutaneous nephrostomy drainage were excluded. Patients without any visualisation of stone on abdominal X-Ray done at 4 weeks of the procedure were labelled as stone-free.
One hundred and three cases with stones >10 mm and fulfilling the selection criteria were included. The mean age was 40.83 + 14.92 years. The mean stones size was 13.33 + 4.64 mm. The mean procedure time was 41.50 + 15.60 minutes. Indwelling JJ stents were placed in 49 (47.6 %) cases. The stone-free rate was 83.5% at four weeks with calculated efficiency quotient (EQ) of 0.72, using a standard equation. The overall complication rate was 27% with the majority being minor (Clavian-Dindo grade 1). Only one patient had urosepsis (MCG IV). Ancillary procedures were performed in 17 (16.5%) cases, most commonly the extracorporeal shock wave lithotripsy (ESWL) in 14 (13.5%) cases, followed by the secondary URS in 3 (2.9%) cases.
Semi-rigid URS is an effective and safe procedure for the large proximal ureteral stones, with limited access to flexible instruments. Key Words Ureteroscopy, Semi-rigid, Stone, Proximal, Clearance, Safety.
Semi-rigid URS is an effective and safe procedure for the large proximal ureteral stones, with limited access to flexible instruments. Key Words Ureteroscopy, Semi-rigid, Stone, Proximal, Clearance, Safety.
To explore diagnostic values of sCD163 with PCT and HS-CRP in diagnosing infection among patients with gynecological malignant tumors and fever.
Cross-sectional, observational study.
Huzhou Maternity & Child Health Care Hospital, China, from May 2018 to February 2020.
A total of 119 patients with gynecological malignant tumors and fever were divided into infected group (70 cases) and non-infected group (49 cases), according to the blood bacterial culture results and clinical symptoms. Serum PCT, HS-CRP, sCD163 level were compared. Pearson correlation was performed to analyse correlation of sCD163 with PCT and HS-CRP. The area under the curve (AUC) score was calculated from receiver operating characteristic curve (ROC).
Serum sCD163, PCT and HS-CRP levels in infected group were all elevated compared to non-infected group (all p <0.001). Pearson correlation analysis showed that sCD163 was positively correlated with PCT and HS-CRP (r = 0.596, p <0.001; r = 0.744, p <0.001, respectively). The AUC of sCD163 + PCT + HS-CRP combined detection for predicting early infection in patients with gynecological malignant tumors and fever was 0.
